From computers to middle-class clinics

New Delhi, Feb. 6: Shiv Nadar, the engineer-turned-entrepreneur who had used a garage apartment 38 years ago to start what has become the fourth largest Indian information technology company, has now ventured into health care, promising a nationwide chain of multi-speciality clinics.

Nadar, founder-chairman of HCL, today announced the launch of its health care initiative, beginning with clinics that would initially provide diagnostic and treatment services in four medical areas — asthma and other respiratory illnesses, diabetes, gastroenterology and dermatology.

Patients from India’s middle-class households would form the primary target market for the clinics where, executives said, the fees for consulting with doctors would be competitive — ranging from Rs 400 to Rs 800.

Analysts feel that the initiative is likely to provide competition to single-doctor clinics found in towns and cities across the country.

HCL Healthcare, through a subsidiary named HCL Avitas, has established two clinics with 12 doctors in Gurgaon and Noida in the National Capital Region and plans to expand with clinics in towns across India that will employ at least 1,500 doctors within five years. “We’re approaching this with all humility,” Nadar said. “This is a natural adjacent space for us to get into.”

HCL, which has an annual revenue of $6.4 billion, has been indirectly involved in the health care arena through its technology services provided to medical devices companies worldwide. The HCL Avitas clinics have partnered with Johns Hopkins Medicine International (JHMI), a unit of the Johns Hopkins Hospital in Baltimore, the US, to provide health care services to patients exclusively through outpatient consultations.

Experts from the JHMI will guide doctors in the clinics on the best standard treatment protocols and the practice of evidence-based medicine, said Harish Natarajan, the chief executive officer of HCL Avitas.

The clinics will refer patients who require in-patient care to hospitals.

HCL Healthcare officials declined to name other towns where they plan to establish its clinics, but said they hoped to steadily expand the network over the next five years to provide care to over 20 million patients by the year 2020.

“We’re already talking to 35 more doctors who could be part of our current or future clinics,” Natarajan said. Over time, the clinics will also widen the range of medical areas for which they will offer diagnostic and treatment services.

Nadar has set aside Rs 1,000 crore as equity for the health care initiative. “We don’t plan to list for the next 10 years — so we’ll be under no pressure to maximise profits per doctor,” said Nadar, who had left a job in 1976 to create with seven colleagues a company to promote microprocessor technology that has evolved into HCL, which now employs 91,000 people in 34 countries.

Members of India’s health care sector believe the clinics set up by HCL, depending on where they are located, are likely to provide competition to single-doctor clinics.

“Competition would be good, we need much more competition in the private health care sector than we have right now,” said Chandra Gulhati, a pharmacologist and the editor of the Monthly Index of Medical Specialities, India, a journal of drugs.

He said the concept of introducing standard treatment protocols uniformly across a chain of clinics was good and would benefit patients. “But,” Gulhati cautioned, “networks of clinics linked to any brand could at times be misleading because medical treatment delivery through doctors cannot be standardised like the manufacture of cars or computers.”

Nadar had in 1996 established an engineering college in Chennai and has since then set up schools for socially underprivileged students, and a university. But, an HCL official said, his education initiatives are all philanthropic, not-for-profit projects.